Vuitch M F, Rosen P P, Erlandson R A
Hum Pathol. 1986 Feb;17(2):185-91. doi: 10.1016/s0046-8177(86)80292-1.
Grossly circumscribed, nonhemorrhagic breast masses consisting of mammary stromal proliferations that simulated vascular lesions were studied in nine women. Histologically, a striking pattern, which appeared to consist of complex inter-anastomosing channels lined by slender spindle cells, was present in the mammary parenchyma. The importance of this benign lesion, referred to as pseudoangiomatous hyperplasia of mammary stroma, is its distinction from angiosarcoma. The patients ranged in age from 22 to 52 years; all were premenopausal. Each presented with a palpable unilateral mass, measuring up to 7 cm in diameter. The patients were treated by excisional biopsy and remained well for up to 2.5 years after excision. One patient had two local recurrences within one year of the original excision, and a second patient had a local recurrence at 14 months. No patient had another concurrent or metachronous malignant tumor of the breast or other organ, and no abnormal hormonal status was found. Complete local excision appears to be adequate treatment. It remains to be determined whether this is a neoplastic process. However, there is no evidence that it is a precursor of angiosarcoma, and ultrastructural observations demonstrate that the spaces found in the lesion are not true vascular channels. Rather, they appear to arise by a process that involves disruption and separation of stromal collagen fibers. Since small foci of this change are common in hyperplastic breast tissue from premenopausal women, it is likely that the development of a discrete tumor with this pattern represents an exaggerated form of stromal hyperplasia.
对9名女性中出现的大体上边界清晰、非出血性的乳腺肿块进行了研究，这些肿块由模拟血管病变的乳腺间质增生构成。组织学上，乳腺实质中存在一种显著的模式，似乎由细长梭形细胞内衬的复杂相互吻合的通道组成。这种被称为乳腺间质假血管瘤样增生的良性病变的重要性在于它与血管肉瘤的区别。患者年龄在22岁至52岁之间；均处于绝经前。每位患者均表现为可触及的单侧肿块，直径达7厘米。患者接受了切除活检治疗，切除后长达2.5年情况良好。1例患者在初次切除后1年内出现2次局部复发，另1例患者在14个月时出现局部复发。没有患者同时或异时发生乳腺或其他器官的恶性肿瘤，也未发现激素状态异常。完整的局部切除似乎是充分的治疗方法。这是否是一个肿瘤性过程仍有待确定。然而，没有证据表明它是血管肉瘤的前驱病变，超微结构观察表明病变中发现的间隙不是真正的血管通道。相反，它们似乎是由一个涉及间质胶原纤维破坏和分离的过程产生的。由于这种变化的小病灶在绝经前女性的增生性乳腺组织中很常见，具有这种模式的离散肿瘤的发生可能代表了间质增生的一种夸张形式。
